Provider Demographics
NPI:1154021608
Name:HAN, CHRISTINA EUNHAE (PTA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:EUNHAE
Last Name:HAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 GREEN MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-3236
Mailing Address - Country:US
Mailing Address - Phone:916-990-6911
Mailing Address - Fax:
Practice Address - Street 1:402 DEWEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1425
Practice Address - Country:US
Practice Address - Phone:415-242-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
51989225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant